Wednesday, May 4, 2011

Patients I can deal with, families I really can't. You don't get to tell me you won't pick up your 96-year-old mother for discharge until next Tuesday... because you "aren't ready to deal with her yet." Yes, dealing with frail, ill, elderly parents is without a doubt difficult, and, yes, I have sympathy... but this is not a babysitting service, it's a hospital, and the bed needs to go to someone else, and without any medical condition keeping her here, what are we supposed to do? "If you can't take care of her, I need to get social services involved." "No." "Then tell me what we should do." "Leave her where she is. We will come next Tuesday. Unless she gets sick again before then." "She has a better chance of getting sick if she stays in the hospital." "Then she'll have to take that risk." "I am getting social services involved." "Then I want to speak to your supervisor."

Because what I'm doing is sitting at a customer service phone bank and let me just get my manager to solve your problem. Ugh. It is hard not to yell at people sometimes.

From the other side, though: imagine someone trying to figure out how they're going to keep their job and take care of a 94 year old who's not quite ill enough to be in the hospital. What would you do if someone said, you have to pick up your parent today. Period. Would you quit residency? Do you have enough money to pay for somone else to provide full time care? Would you expect someone else to take care of it?

Sounds like this woman needed to be in assisted living. At least for the moment, that is still covered by Medicare/Medicaid for those who can't afford it and have depleted there other resources. And yes, I can also imagine the difficulty of stopping my life and caring for a family member - but that does not justify this person's reaction. Nor does it make it a matter for the health care system once the woman is well - it does seem more appropriately a matter for the social service system.

Assisted living is not covered by Medicare, and if you cannot justify a patient being in the hospital, the family need to be made aware that Medicare will not cover her stay in the hospital either. You need to get social services involved, so they can possibly transfer her to long term care, sub acute rehab/care or other type facility. If she had a 3 day stay in the hospital, this would be covered by Medicare.